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Accuracy of fit of monopolar radial head prostheses in the proximal radioulnar joint
Background. Currently available radial head prostheses reproduce the variable anatomy of the proximal radius only to a limited extent. This could influence the anatomy and kinematics of the proximal radioulnar joint (PRUJ), which has not yet been fully investigated. Objectives. The aim was to analyze the native joint congruity of the PRUJ depending on forearm rotation and to compare the results to the joint congruity after monopolar radial head replacement. Materials and methods. A total of 20 formalin-fixed elbow joint specimens were available for this study. Optosil putty impressions of the joint space of the PRUJs were obtained from the native specimens and following radial head replacement (MoPyC, Tornier, France) in neutral rotation, in 80 degrees pronation and in 80 degrees supination. Axial sections of these impressions were performed at the upper and lower borders as well as in the middle of the lesser sigmoid notch of the ulna. The respective joint spaces at the anterior edge, at the center and at the posterior edge of the PRUJ were then measured digitally. Results. The native radial head is centered within the lesser sigmoid notch in neutral rotation. It shifts anteriorly in pronation and posteriorly in supination, which also applies to the radial head implant; however, the anterior and posterior shift of the radial head replacement is significantly more pronounced which leads to a misalignment of the PRUJ with gaping of the joint space of up to 3 mm at either the anterior or posterior edge of the joint. Conclusion. Radial head prostheses reduce the contact area to the lesser sigmoid notch. This could lead to an imbalance of contact pressure in the PRUJ with subsequent development of osteoarthritis, which might cause pain and a decrease in range of motion.
Accuracy of fit of monopolar radial head prostheses in the proximal radioulnar joint
Background. Currently available radial head prostheses reproduce the variable anatomy of the proximal radius only to a limited extent. This could influence the anatomy and kinematics of the proximal radioulnar joint (PRUJ), which has not yet been fully investigated. Objectives. The aim was to analyze the native joint congruity of the PRUJ depending on forearm rotation and to compare the results to the joint congruity after monopolar radial head replacement. Materials and methods. A total of 20 formalin-fixed elbow joint specimens were available for this study. Optosil putty impressions of the joint space of the PRUJs were obtained from the native specimens and following radial head replacement (MoPyC, Tornier, France) in neutral rotation, in 80 degrees pronation and in 80 degrees supination. Axial sections of these impressions were performed at the upper and lower borders as well as in the middle of the lesser sigmoid notch of the ulna. The respective joint spaces at the anterior edge, at the center and at the posterior edge of the PRUJ were then measured digitally. Results. The native radial head is centered within the lesser sigmoid notch in neutral rotation. It shifts anteriorly in pronation and posteriorly in supination, which also applies to the radial head implant; however, the anterior and posterior shift of the radial head replacement is significantly more pronounced which leads to a misalignment of the PRUJ with gaping of the joint space of up to 3 mm at either the anterior or posterior edge of the joint. Conclusion. Radial head prostheses reduce the contact area to the lesser sigmoid notch. This could lead to an imbalance of contact pressure in the PRUJ with subsequent development of osteoarthritis, which might cause pain and a decrease in range of motion.
Accuracy of fit of monopolar radial head prostheses in the proximal radioulnar joint
Hackl, Michael (author) / Wegmann, Kilian (author) / Helf, Charlotte (author) / Neiss, Wolfram Friedrich (author) / Mueller, Lars Peter (author) / Burkhart, Klaus Josef (author)
2015-01-01
Hackl, Michael orcid:0000-0002-6183-5621 , Wegmann, Kilian, Helf, Charlotte, Neiss, Wolfram Friedrich, Mueller, Lars Peter and Burkhart, Klaus Josef (2015). Accuracy of fit of monopolar radial head prostheses in the proximal radioulnar joint. Obere Extremitaet-Schulter-Ellenbogen-Hand, 10 (4). S. 246 - 252. HEIDELBERG: SPRINGER HEIDELBERG. ISSN 1862-6602
Article (Journal)
Electronic Resource
German
DDC:
710
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